Hydrocele
- Distinguishing from hernias
- Can pinch off and feel cord structures above
- Transilluminate more than hernias
- Types
- With patent processus vaginalis
- Increasing volumes of fluid can get trapped
- Potential for hernia formation too
- Without PPV
- Usually resolve without intervention within 18 months
- Consequences
- None really
- cf Varicocele (raised temp causes infertility)
- Watchful waiting generally fine
- Frequency
Inguinal hernias
- Distinguishing
- Can't get above it
- Easier to reduce
- Frequency
- Risk of incarceration
- 50% at 6 months
- 7% at 1 year
Pyloric stenosis- Develops over the first month of life
- Tends to present at 5-6 weeks
- Treat by making an incision in the mucosa, allowing the muscular tissue of the sphincter to expand outwards
Undescended testes
- Frequency
- Outcome
- 65% fix themselves within 6 months
- Wait 6 months, then operate
- Risks
- 90% also have PPV
- => May present with hernia
- 1% risk of testicular cancer if not fixed by puberty
- NB testes can re-ascend during rapid pubertal growth
Testicular torsion
- Occurrence
- Presentation
- Excruciating pain over whole testicle
- Ascending pain
- Inguinal / iliac fossa
- Careful to distinguish from appendicitis!
Umbilical hernia
- 30% of neonates
- Almost never obstruct
- => Watchful waiting
Idiopathic scrotal oedema
- Usually bilateral
- cf torsion, (epididymo)-orchitis
- Raw red skin over and around testicle
- But testes are not tender underneath
- Resolves in 2-3 days without intervention
Balanitis
- Inflammation of the glans of the penis
- Distinguish from just the tip
- cf Balanitis xerotica obliterans
Duodenal atresia
- "Double-bubble" sign on X-ray
- Stomach + proximal duodenum
- Bile-stained vomit
- Extremely serious
- Transfer immediately to tertiary pediatric surgery centre
Lower intestinal obstruction- Hirschsprung's disease
- Caused by the failure of the neural crest cells to migrate completely
- Intestine doesn't relax => Blockage
- Meconium ileus
Vitello-intestinal Duct Remnants - Vitello-intestinal duct or omphalo-mesenteric duct connects the midgut to the yolk sac during early embryonic life
- It gets obliterated and disappears during fifth to sixth week of intrauterine life.If the remnants persists then following abnormalities can occur:
- Umbilical Polyp
- Umbilical Sinus
- Fibrous remnant of vitello-intestinal duct
- Meckel's Diverticulum
- Patent Vitello-intestinal duct
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